Remote Medical Director - Health Plan Medical Policy
$174.07k - $374.92kHispanic Alliance for Career Enhancement
- Remote job
Hispanic Alliance for Career Enhancement seeks a Medical Director to oversee medical policy and support medical management programs in Arizona. This fully remote role requires an active medical license and at least two years of experience in health care delivery. Responsibilities include engaging with clinical teams, conducting reviews, and participating in on-call rotations. The salary ranges from $174,070 to $374,920, with a comprehensive benefits package available. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
- ...FLR PCHP - Parkland Community Health Plan Remote PRIMARY PURPOSE Oversees medical coordination required for... ..., Quality Management, Clinical Policy, Technology Assessment, Credentialing... ...Texas for Managed Care Medical Directors. Board certification in the...Remote workPolicyHealth InsuranceContract workWork at officeLocal area
- ...Plan Performance Medical Director- Missouri Medicaid Market Plan Performance Medical Director- Missouri... ...collaboration. Please note that per our policy on hybrid/virtual work, candidates... ...clinical program operations within the health plan. The individual will collaborate...Remote workPolicyHealth InsuranceFull timeDay shift
- ...demonstrate those values Every. Single. Day. Aspirus Health Plan is seeking a Director - Medical Director to join our team in Wausau, WI ! The... ...utilization management (medical and pharmacy), appeals, medical policy (development and maintenance), and quality improvement...PolicyHealth InsuranceFull timePart time
$121.7k - $202.9k
...Operations Director As the Express Scripts Inc. (ESI) Health Plans Division (HPD) Operation Director... ...mentoring on-site and remote team members Work collaboratively... ...benefits including medical, vision, dental, and... ...has a tobacco-free policy and reserves the right...Remote workPolicyHealth InsuranceWork experience placementLocal areaWork from homeShift workNight shift$250k - $300k
...Strategic Medical Director, MSK United States Opportunity Overview... ...of Cohere's clients (i.e., health plans, health systems, & ACOs). You... ...utilization management and medical policy programs/areas as necessary... ...Pay & Perks: Fully remote opportunity with about 25% travel...Remote workPolicyHealth InsuranceFlexible hours- ...determining appropriateness and medical necessity of member dental... ...leadership to establish strategic plans and objectives. Contributes to... ...profiling analytics, dental policies and procedures and quality improvement... ...in state of practice. Health care management/leadership...Remote jobPolicyHealth InsuranceWork at office
- Blue Cross and Blue Shield of Louisiana Inc. seeks a Medical Director to oversee treatment procedures and ensure compliance with established guidelines. This role includes responsibilities for utilization management, case management, and disease management. Qualified candidates...PolicyHealth Insurance
- ...System Physician Advisor Medical Director Responsibilities and... ...: The Lee Health System Physician Advisor... ...(including discharge planning), and social services... ...providers involved in remote utilization review and... ...allowed per Lee Health policy. • Onsite presence...Remote workPolicyHealth InsuranceContract workFor contractorsMonday to FridayWeekend work3 days per week
$174.07k - $374.92k
The Hispanic Alliance for Career Enhancement is offering a remote position with Aetna, a leader in health insurance, focused on expanding medical management programs. The role requires an MD or DO, with extensive experience in health care delivery and utilization management...Remote jobHealth Insurance$135k - $150k
...The Sales Director- Health Plan will report directly to the VP of Sales – Health Plan and have responsibility... ...Good Health Comprehensive Medical, Dental, and Vision insurance plans... ...Happiness Excellent PTO policy (everyone deserves a vacation now and...Remote workPolicyHealth InsuranceContract workTemporary work$248.5k - $373k
...seeks a qualified MD or DO for a remote position focused on managing health plan appeals and grievances. The role... ...to communicate effectively with medical directors. You will also provide clinical... ...candidates must adhere to telecommuter policies and the workplace is drug-free....Remote jobPolicyHealth Insurance$250k
...The Utilization Review Medical Director is responsible for conducting clinical reviews... ...and Medicaid guidelines, health plan–specific criteria, internal policies, and regulatory requirements. This... ...Additional Expectations: Full-time remote role requiring consistent...Remote workPolicyHealth InsuranceFull timeTemporary workLocal area$202k - $303k
...Medical Director The Medical Director participates in the broad array of activities of the... ...management, member care management, and medical policy processes, and support for our various... .... Ability to travel across the Health Plan service region for meetings and/or...Remote workPolicyHealth InsuranceContract workWork at officeLocal areaWork from homeHome officeAfternoon shift$280.84k - $393.18k
...Senior Medical Director Policy & Outcomes Find joy in serving others with IEHP... ...to the Vice President of Health Services, the Senior Medical... ...as well as effective health plan performance as per DHCS, DMHC... ...work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho...Remote workPolicyHealth InsuranceTemporary workLocal areaFlexible hours- ...subject to change. This is a remote position. Must reside in... ...Under limited supervision, the Medical Director is responsible for providing clinical oversight of the Health Plan’s utilization, quality,... ...and direction for clinical policies, procedures, and programs....Remote workPolicyHealth InsuranceContract workFlexible hours
$206.01k
...Purpose: The Behavioral Health Medical Director provides medical leadership to specific health plan or LOB to include overseeing... ...and implementing medical policies and standards, evaluating new... ...40-hours/week) Monday-Friday REMOTE in South Carolina. You will...Remote workPolicyHealth InsuranceFull timePart timeFor contractorsWork experience placementLocal areaMonday to Friday$248.5k - $373k
...enjoy the flexibility to work remotely from anywhere within the U.... ...The Appeals and Grievances Medical Director is responsible for ongoing... ...and grievances for various health plan and insurance products,... ...clinical criteria of medical policies. Perform Department of Insurance...Remote jobPolicyHealth InsuranceMinimum wageWork experience placementLocal areaWork from home$122.44k
...administration of the Medical Review and Prior Authorization... ...the integration of policy and education, that... ...Location: This is a remote position. Typical work... ...and error rate reduction plans based on the findings.... ...therapy & impact to future health care costs and quality....Remote workPolicyHealth InsuranceContract workFor contractorsWork experience placementWork at officeLocal areaMonday to Friday- ...Medical Director – Utilization Management As part of a physician team,... ...electronically using Medical Policy criteria sets to evaluate the... ...Management experience within a health insurance environment. Candidates... ...within a Health Insurance Plan. Strong knowledge of the...Remote workPolicyHealth InsurancePrivate practice
$248.5k - $373k
...we're simplifying the health care experience, creating... ...flexibility to work remotely from anywhere within... ...Appeals and Grievances Medical Director is responsible for ongoing... ...for various health plan and insurance products... ...criteria of medical policies. Perform Department of...Remote jobPolicyHealth InsuranceMinimum wageWork experience placementLocal areaWork from home$174.07k - $374.92k
...building a world of health around every... ...care resources. Remote based (work from home... ...Arizona and have a medical license without encumbrances... ...) In the Medical Director role you will... ...for medical policy implementation. You... ...experience with a Health Plan / Payor. Previous...Remote workPolicyHealth InsuranceHourly payFull timeTemporary workLocal areaWork from homeNight shiftWeekend work$275k - $325k
...Medical Director, Vision Job Category: Director Requisition... ...2026 Full-Time Remote Pay or shift range:... ...services. Ensure clinical policies, guidelines, and... ...specialist for Health Network One's vision service... ...stakeholders, including health plans, provider partners,...Remote workPolicyHealth InsuranceFull timeShift work- ...Job Title: Medical Director - Utilization Management Location: Remote - Preference EST or nearby Pittsburgh... ...using Medical Policy criteria sets to evaluate... ...Management experience within a health insurance environment.... ...a Health Insurance Plan. Strong knowledge...Remote workPolicyHealth InsuranceContract workPrivate practice
- ...Associate Medical Director Rooted in Wyoming! We are Blue... ...Wyoming: a not-for-profit health insurer with offices... ...care as a health plan entity for the members... ...as guided by medical policy for both medical and pharmacy... ...experience. Remote work is a consideration...Remote workPolicyHealth InsuranceFull timeWork at officeLocal areaWork from homeVisa sponsorshipWork visa
$180.8k - $226k
...individual for the position of Director Health Planning for the design practice, to... ...benefit package including medical, dental and vision coverage... ...off, flex-time schedules, remote work options and a 401k... ...and adhere to our internal policies and our Code of Conduct. CannonDesign...Remote jobPolicyHealth InsuranceFor contractorsWork experience placementFlexible hours- ...JOB DESCRIPTION Medical Director - Utilization Management... ...Experience Required)- (Remote) Duration: 30... ...Management activities within a health insurance/payer... ...established medical policy criteria. The Medical... ...within a health insurance plan environment....Remote workPolicyHealth InsuranceFull timeContract workPart timePrivate practiceMonday to FridayFlexible hours
- Position: Associate Medical Director - Health Plan Full/Part Time: Full time Location: Houston, TX, US Department: Medical Affairs Shift: 8a... ...be responsible for establishing health plans and medical policies. The Associate Medical Director provides guidance to areas...PolicyHealth InsuranceFull timePart timeWork at officeLocal areaShift work
$281.11k
...Medical Director (Part-Time) Main Office - Santa Barbara,... ...Type Part Time Category Health Services... ...will work a hybrid or remote schedule depending on... ...that have an impact on plan benefits and their administration... ...as needed; develops UM policies and procedures in coordination...Remote workPolicyHealth InsuranceContract workPart timeWork at officeLocal areaRelocationRelocation package$120k - $145k
...Overview The Medical Policy Director (MPD) is a key member of the Go To Market team. Along with... ...Management (PPM) client team at the health plan. The MPDs role is to serve as a... ...and Physical Requirements: This remote role can be located anywhere in the continental...Remote workPolicyHealth InsuranceWork experience placementWork at officeImmediate start$215k - $408.5k
...clinical professional on our Medical Management/Health Services team. Centene... ...: Full time Medical Director for our Oklahoma Health Plan! Centene Corporation... ...establishing goals and policies to improve quality and... ...approach to work with remote, hybrid, field or office...Remote workPolicyHealth InsuranceFull timePart timeWork at officeFlexible hoursWeekend work
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